Clinical profile and admission pattern of neonates in a special newborn care unit of a rural district hospital; a two-year experience from Dhading hospital

Abstract

Introduction: Neonatal mortality rate (NMR) is 21 per 1000 live births as per the Nepal demographic health survey (NDHS) 2022, with no significant decline in the last decade. Neonatal mortality can be reduced if quality of care can be provided from a special newborn care unit (SNCU) at the periphery.  Hence, this study aims to describe the clinical profile, disease patterns, and outcomes of neonates admitted to a level II SNCU in a rural district hospital, providing evidence to strengthen neonatal care services in similar settings.

Method: A retrospective study was conducted at Dhading Hospital for 2 years, from Mangsir 2079 (16th November 2022) to Kartik 2081 (15^th November 2024). Data on gender, gestational age, presenting symptoms, final diagnosis, and outcome were collected from hospital records and analyzed in Microsoft Excel 2013.

Result: A total of 704 neonates were studied. Neonatal jaundice 241 (34.23%) was the commonest cause of admission, followed by sepsis 195 (27.70%) and perinatal asphyxia 92 (13.07%).  Likewise, 581 (82.53%) were term, 38 (5.40%) were post-term, and 85 (12.07%) were premature. Out of 1450 births during a 2-year period, 23 (1.59%) babies had congenital anomalies. Similarly, 643 (91.33%) babies were discharged from SNCU, whereas 38 (5.40%) were referred to level 3 care, and 8 (1.14%) expired.

Conclusion: Enhancing the level 2 neonatal care unit at a peripheral hospital improves outcomes. Establishment of functional SNCU should be prioritized as a key strategy to reduce neonatal mortality in Nepal.